JEFFREY HOWARD WACHHOLZ (NPI# 1508981689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508981689 |
| Entity Type | Individual |
| Full Name | JEFFREY HOWARD WACHHOLZ |
| Credential | M.D. |
| Practice Address |
2700 Riverside Ave Suite 7 Jacksonville FL 32205-8275 |
| Practice Telephone | 9043893223 |
| Practice Fax Number | 9043885902 |
| Mailing Telephone | 9043893223 |
| Mailing Fax Number | 9043885902 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
ME76268 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 46857 | 01 |
| AVMED | 288187 | 01 | |
| FL | AETNA | 7137740 | 01 |
| Street Address |
2700 RIVERSIDE AVE SUITE 7 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32205-8275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548257041 | Jacksonville Beaches Medical Imaging Inc | Clinic/Center | 2700 Riverside Ave, Suite 1, Jacksonville, FL 32205-8275 | 2005-09-30 |
| 1952706368 | Physicians Group Services Pa | Family Medicine | 2700 Riverside Ave, Suite 2, Jacksonville, FL 32205-8275 | 2014-10-28 |
| 1043524119 | Renee Gallo | Anesthesiology | 2700 Riverside Ave, Jacksonville, FL 32205-8275 | 2010-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003466830 | Brandon Neil Hillard | Registered Nurse | 1260 Mcduff Ave. South, Suite 4, Jacksonville, FL 32205 | 2019-09-13 |
| 1720436363 | Ericka Sampson | Massage Therapist | 6859 Lenox Ave., Suite 6, Jacksonville, FL 32205 | 2016-05-24 |
| 1578921631 | Northstar Counseling | Counselor | 1672 Pershing Rd, Jacksonville, FL 32205 | 2016-02-04 |
| 1649645144 | Magaly Perez-cruz | Speech-Language Pathologist | 4101-1 College Street, Jacksonville, FL 32205 | 2015-12-09 |
| 1639448723 | First Choice Adult Daycare and Home Health Ca | Specialist | 5336 Quan Drive, Jacksonville, FL 32205 | 2011-12-20 |
| 1437434222 | Christopher Styer | Pharmacist | 654 Casset Ave, Jacksonville, FL 32205 | 2011-10-12 |
| 1871827279 | April Marie Felton | Nurse Practitioner | 500 E. Adams Street, Bay Street Health Center, Jacksonville, FL 32205 | 2009-10-01 |
| 1922244821 | Danielle Marie Sergent | Physical Therapist | 5222 Lenox Ave., Jacksonville, FL 32205 | 2008-12-23 |
| 1427181775 | Lapp & Associates Behavioral Counselind Ctr | Counselor | 931 Cassat Avenue, Jacksonville, FL 32205 | 2007-03-14 |
| 1629143326 | Elias Moussa Sargi | Dentist | 2700 Riverside Avenue, Ste 10, Jacksonville, FL 32205 | 2006-11-21 |
| Find all providers in zip 32205 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306035951 | Jacksonville Otolaryngology & Facial Plastic Surgery | Otolaryngology | 836 Prudential Dr Ste 807, Jacksonville, FL 32207-8335 | 2007-10-19 |
| 1265492656 | Scott Andrew Scharer | Otolaryngology | 836 Prudential Dr Ste 1601, Jacksonville, FL 32207-8343 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093228587 | Cosmetic Medicine Enterprises Inc | Otolaryngology | 34156 Us Hwy 19 N, Palm Harbor, FL 34684 | 2017-11-07 |
| 1205362183 | Clifton Bridges | Otolaryngology | 6970 Sunnyside Dr, Leesburg, FL 34748-9556 | 2017-05-11 |
| 1811305568 | Medney Tardy Jr. | Otolaryngology | 651 Jacana Cir, Naples, FL 34105-7400 | 2014-07-25 |
| 1699113605 | Lebeau Clinic Pl | Otolaryngology | 1020 N Palafox St, Pensacola, FL 32501-3118 | 2013-06-12 |
| 1164867644 | Joseph Samuel Moak IIi | Otolaryngology | 1819 Salk Ave, Tavares, FL 32778-4311 | 2013-05-09 |
| 1750661328 | Jesse Andrew Burnam | Otolaryngology | 15647 Carriedale Ln, Fort Myers, FL 33912-3904 | 2011-08-26 |
| 1619276102 | Thomas Lewis Tzikas | Otolaryngology | 526 Se 5th Ave, Delray Beach, FL 33483-5213 | 2011-03-23 |
| 1356595268 | Vijay M Sharma | Otolaryngology | 601 University Blvd Ste 201, Jupiter, FL 33458-2788 | 2008-11-05 |
| 1881846731 | Anthony Bared | Otolaryngology | 6280 Sunset Dr Ste 504, South Miami, FL 33143-4870 | 2008-10-22 |
| 1700034345 | Larry Nelson Smith | Otolaryngology | 10925 Sw 27th Ave, Gainesville, FL 32608-8937 | 2008-09-08 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32205 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.